Case Report of Electroconvulsive Therapy in a Patient With Parkinson Disease Concomitant With Deep Brain Stimulation

Nasr, Suhayl; Murillo, Anne; Katariwala, Nasar; Mothkur, Venkat; Wendt, Burdette

doi:10.1097/yct.0b013e3181da843c

Cited by 16 publications

(19 citation statements)

References 8 publications

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“…40 Case reports also revealed that ECT can be used for MDD in combination with DBS targeting the subcallosal cingulate gyrus, in TRD, 27,28,37 or the VC/VS, in OCD. 33 When identified by authors, the DBS devices used were the Medtronic system 3,23,26,[29][30][31]34,42 and a rechargeable implantable pulse generator (St Jude Medical, St Paul, Minnesota). 37 Electroconvulsive therapy electrodes can be positioned either bifrontally (BF) 24,27,30,37,38,40,41 or bitemporally (BT), 23,26,28,29,[31][32][33][34][35]39 but a large number of articles indicated placement as far away from the DBS lead insertion point and the connecting cable as possible.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Electroconvulsive Therapy in Patients With Deep Brain Stimulation

Bukowski

Laurin

Laforgue

et al. 2022

J ECT

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Deep brain stimulation (DBS) has proven to be an effective therapy of some treatment-resistant psychiatric disorders and movement disorders. Comorbid depressive symptoms are common and difficult to manage. Treatment with electroconvulsive therapy (ECT) may be required. There are few published cases describing the safety and efficacy of ECT for patients with DBS implants, and there are no available guidelines for administration of ECT in patients with DBS and mood disorders. The current study had 3 aims: (i) to conduct a systematic review of case reports on patients with DBS implants who received ECT; (ii) to report the case of a 69-year-old man with a DBS implant for essential tremor, who required ECT; and (iii) to provide practical recommendations for ECT in patients with DBS implants. Methods:We conducted a systematic review, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, of existing case reports on patients with DBS implants administered ECT for psychiatric disorders.Results: Our search yielded 25 cases of ECT in patients implanted with DBS systems. In addition, we here describe successful ECT management of major depressive disorder in a patient treated by DBS. We also set forth ECT management guidelines based on points of consensus. The 2 most important practical recommendations are to make sure the DBS system is set to 0 V and turned off before ECT, and to avoid sites near the DBS electrodes.Conclusions: Electroconvulsive therapy may be an effective and safe treatment for DBS patients with MDD.

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Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Electroconvulsive Therapy in Patients With Deep Brain Stimulation

Bukowski

Laurin

Laforgue

et al. 2022

J ECT

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“…Furthermore, the stimulation of DA release, in addition to stimulation of other monoaminergic effects, may also play a role in the antidepressant and antipsychotic effects of ECT. In recent years, several case reports [12,[69][70][71] have demonstrated the efficacy and safety of ECT in PD patients with severe, unremitted depressive and/or psychotic features, even implanted with deep-brain stimulation devices [for a review see ref . 41 ].…”

Section: Discussionmentioning

confidence: 99%

Antiparkinsonian Mechanism of Electroconvulsive Therapy in MPTP-Lesioned Non-Human Primates

et al. 2012

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Background: Electroconvulsive therapy (ECT), an effective treatment for depression, also improves motor symptomatology in Parkinson’s disease (PD). We have previously demonstrated that ECT stimulates dopamine (DA) function in the striatum of healthy non-human primates, suggesting that DA may contribute to antidepressant effects. Objective: We investigated the potential role of DA mechanisms in the amelioration of PD symptoms following a clinical course of ECT. Methods: We treated non-human primates rendered mildly bilaterally or unilaterally parkinsonian with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), with a course of 6 ECT treatments. Using positron emission tomography, animals were scanned at baseline and at various time points after ECT with tracers of the DA system. Data were analyzed using the Logan reference tissue model and statistics were performed using orthogonal polynomial contrasts. Results: There was no change in binding of the DA transporter tracer in the lesioned striata after ECT as opposed to what we measured in the striatum of healthy animals. Raclopride binding to the D_2/3 receptors was unaffected in all groups. However, there were increases in vesicular monoamine transporter type 2 and D₁ receptor binding in the MPTP-lesioned striata after ECT, returning towards baseline by 6 weeks. Conclusion: We suggest that the effects of ECT in PD may proceed from a mechanism similar to that in healthy animals but with a blunted dopaminergic response, likely due to the significant loss of striatal DA terminals. The safety of ECT, its mild side effects and its stimulatory effects of the DA system may thus make it an attractive adjunct to antiparkinsonian treatment.

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“…Some case reports suggest that electroconvulsive therapy (ECT) may be an option to consider in patients with PD and comorbid depression [155][156][157][158][159][160][161] or psychosis. 162,163 Open-label studies have also suggested that repetitive transcranial magnetic stimulation (rTMS) may have utility in the treatment of depression in PD.…”

Section: Nonpharmacological Interventions For Emotional Disturbances mentioning

confidence: 99%

Psychiatric Care in Parkinson’s Disease

Quelhas¹

2013

Journal of Psychiatric Practice

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Case Report of Electroconvulsive Therapy in a Patient With Parkinson Disease Concomitant With Deep Brain Stimulation

Cited by 16 publications

References 8 publications

Efficacy and Safety of Electroconvulsive Therapy in Patients With Deep Brain Stimulation

Efficacy and Safety of Electroconvulsive Therapy in Patients With Deep Brain Stimulation

Antiparkinsonian Mechanism of Electroconvulsive Therapy in MPTP-Lesioned Non-Human Primates

Psychiatric Care in Parkinson’s Disease

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